Disease activity, treatment and long-term prognosis of adult juvenile idiopathic arthritis patients compared with rheumatoid arthritis patients

Abstract

Objective: To evaluate the difference between adult juvenile idiopathic arthritis (JIA, starting at <16 years) and rheumatoid arthritis (RA).

Methods: Data on 128 adult JIA patients were from the National Database of Rheumatic Diseases in Japan (NinJa), 2014, divided into 4 groups by period of disease onset (Group 1: 2000–2013, n = 32; Group 2: 1981–1999, n = 32; Group 3: 1966–1980, n = 31; Group 4: ∼1965, n = 33). Disease activity, treatment and long-term prognosis of adult JIA patients were compared with RA patients matched for sex- and disease duration in each era.

Results: In Groups 1 and 2, adult JIA patients had significantly lower clinical disease activity indices (CDAI) (Group 1: adult JIA 1.5 [0.4–6.9]-vs-RA 5.3 [2.5–10.3], p = .001, Group 2: 2.6 [0.6–9.0]-vs-6.9 [3.5–11.0], p = .001, shown as median [quartile range], p-value, respectively), and had higher CDAI remission rates than RA patients (Group 1: 54.8%-vs-28.2%, p = .002, Group 2: 51.7%-vs-17.0%, p < .001). More adult JIA than RA patients in Group 1 used biologics (62.5%-vs-24.7%, p < .001). However, there were no adult JIA-vs-RA differences in joint destruction and physical function in any group.

Conclusions: Adult rheumatologists must recognize that adult JIA patients are different from RA patients even when disease duration is the same.

Keywords:

• Transition
• adult Juvenile idiopathic arthritis (JIA)
• rheumatoid arthritis (RA)

Acknowledgements

We sincerely thank the physicians who work in the hospitals affiliated with NinJa for their cooperation with our survey. We received invaluable support from Professor Shinichi Uchida. We also thank Ms Tomoko Takahashi for secretarial assistance.

Conflict of interest

Tokyo Medical and Dental University (TMDU) received unrestricted research grants for Department of Lifetime Clinical Immunology from AbbVie GK, Ayumi Pharmaceutical Corporation, Chugai Pharmaceutical Co., Ltd., CSL Behring K.K, Japan Blood Products Organization, Mitsubishi Tanabe Pharma Corporation, Nippon kayaku Co., Ltd., Ono Pharmaceutical Co., Ltd., Towa Pharmaceutical Co., Ltd., UCB Japan Co., Ltd., with which TMDU paid the salary of Fumio Hirano, Toshihiro Matsui, and Masaaki Mori. FH has also received speaking fees from Ono Pharmaceuticals, Astellas Pharma Inc., Sumitomo Dainippon Pharma and Chugai Pharmaceutical Co., Ltd. The other authors declare no conflicts of interest associated with this manuscript.